The 4 Disciplines of Execution


When considering a new innovation to implement in the respiratory care program there were many. E-portfolios stood out mostly to me, when I created my innovation plan I provided a plan to implement e-portfolios into respiratory care education. Students are constantly on the internet. They choose to use google over books for research, they have their phones constantly in their hands, apps are just a click a way, and they have ease of access to the world wide web. That is why I believe e-portfolios could be a great reflection piece for the students to document day to day assignments and competencies. I want to pilot e-portfolios with a focus group in my clinical III course Summer I 2019 with a full roll out to the new incoming students Fall 2019.

The problem we lack with implementing change is getting others on board, keeping ourselves accountable, and not getting stuck in the whirlwind. With this change comes accountability and with accountability is making sure we implement in a timely manner, set certain goals, and produce an effective product. If we look at the five stages of McChesney, Covey, and Huling’s The 4 Disciplines of Execution it will help us implement our plan of change effectively.

The 5 Stages of Δ

Stage1: Getting Clear                                

This is the stage where we set the foundation. We organize our team come up with our Wig, lead, and lag measures. Also, we would develop a way to score our plan and set up a time for weekly meetings as a group to attend!

My team will either get together via phone, email, or via clinical site for a short meeting and develop a plan to set the foundation on how we will get this done.

Stage 2: Launch

This is the kick-off meeting! Recognize your resistors, models, and potentials in this stage. This stage requires more focus from the leader to gather the group and organize the required meeting times.

This meeting will be held on campus for an organizational meeting to see where we go from here. This will be the following week and we will then see who is willing to put in the time and effort to push this forward.

Stage 3: Adoption

In this stage we can see resisters tend to adopt the change and be more enthusiastic about the plan.  They will become accountable for the new level performance despite the demands of the whirlwind.

By this stage I will have started weekly meeting either on site or via video meetings to see who is willing or are we stuck and not pushing forward.

Stage 4: Optimization

At this stage we will see how we are winning and if we aren’t what we need to do to make a change. We will use a scoreboard to make sure we are reaching our goals effectively.

I will have posted the scoreboard via a network drive such as google that we could share since none of my instructors are in the same place at the same time or on campus by my office. We will know who is pushing the idea forward or is staying behind.

Stage 5: Habits

When your ideas get implemented successfully they should be rewarded consistently. We should help individuals become high performers and celebrate their accomplishments. Once, one wig has been completed the leader needs to move on to the next wig and repeat the stages.

I should reward the high performers consistently. Therefore once one goal has been accomplished successfully come up with a plan for a reward and push them on to the next goal. That way we can be successful as a team.

4 Disciplines of Execution

Discipline One: Focus on the Wildly Important

The 4 DX model pushes us to focus and stick to one to two WIGS (Wild Important Goals) at a time to prevent getting lost in the whirlwind.  We sometimes have many goals, but we need to focus on one to two goals that need to be done now and can be successfully implemented. Brainstorming with your team, peers, and alone to see which goal is important could give you great perspective. I tend to want to get everything done at one time. Therefore this statement is very helpful to me. I think focusing on the important goal is the best thing to do. That way you get the most important thing done first and then move on to the next and you do not get as overwhelmed.

MY WIG: To fully integrate E-Portfolios in Fall of 2019 Respiratory Care Program students  that will enable students to document and reflect on their learning experiences.

In the beginning I will be the only one involved in the implementation. The students will be posting one lesson or clinical blog a week for reflection. After, the 2019-2020 implementation I will work with my clinical instructors as well as my program director to achieve similar goals and actions. This brings us to the lag measure that tells us if we have achieved our goal, they mark  a precise finish line for the team (McChesney, Covey, & Huling, 2012). For E-Portfolios the lag measure is developing a plan to give effective feedback by the end of each week. I will have to put lead measures in place to hold myself accountable.


To fully integrate E-Portfolios to the incoming Fall of 2019 Respiratory Care Program students to help students document and reflect on their learning experiences.

Lag Measure

Lead Measure

For E-Portfolios the lag measure is developing a plan to give effective feedback by the end of each week.

 Is for clinical instructors to pair up at clinical sites for weekly WIG meetings 90% of the time.

To allow students thirty to forty-five minutes during a clinical day to work on the e-portfolio to blog or reflect on their clinical experience that day 90% of the time.

Discipline 2: Act on Lead Measures

Lead measures must be both predictive of achieving the WIG and influenced by the team. They must be counterintuitive, they are hard to keep track of, and often look too simple (McChesney, Covey, & Huling, 2012). Lead measures are harder to measure than the lag measures. They are the behind the scenes. If you think of the analogy in the book about dieting  in a whole most people are focused in on the weight in pounds lost. Actually that is you lag measure and technically you should be more focused in on the calories and inches, right? These are your lead measure. We need to be focused on the mustard the details to get the result.

To ensure we have a smooth roll out in the Fall of 2019 we will need to ensure that my team of clinical instructors are meeting in pairs once a week. They usually our on location at clinical sites at least once a week. Therefore, lead measure one is for clinical instructors to pair up at clinical sites for weekly WIG meetings 90% of the time.  This cannot be 100% due to the fact they are not all on the same schedule and they all work at different locations and I am not at the same place at the same time. I also, plan to pair up instructors to get the resistor with an instructor who is more of a influencer on the WIG.

My next lead measure is to allow students thirty to forty-five minutes during a clinical day to work on the e-portfolio to blog or reflect on their clinical experience that day 90% of the time. This cannot be 100% of the time due to unpredictable conditions in the hospital setting. Their day to day plans in the hospital setting is unplanned and unpredictable.  I am hoping these lead measure will ensure 100% on my implementation rollout for 2019 and the future of clinical instructors implementation e-portfolios.


Discipline 3: Keep a Compelling Scoreboard

People play differently when they are keeping score. There’s a remarkable difference between a game where the leader scores the team and a game where the players score each other. It means the team takes ownership of the results. It’s their game to play (McCHesney, Covey, & Huling, 2012). This rings so true, people are competitive in nature. Most of my students are always trying to out due the next. Therefore, if you keep score they are willing to work harder for it.

I will keep score by posting charts on the bulletin board in the hallway by my office and also on google documents for ease of access. Below, shows my lead measure where the student is receive access at the clinical site and the minutes they are receiving each week to work on their e-portfolios:

Next, I could measure my clinical instructor meetings with a chart that shows zero or 100% compliance. I could post it as well on google sheets or docs and along side my office.

Last we could look at the lag measure overall and how could we measure it as a score overall. Below you will find a chart showing the performance overall.

Discipline 4: Create a Cadence of Accountability

I already plan on sending the weekly spreadsheet and updates to the clinical instructors to keep them updated where we are at on our goals. When the weekly WIG meetings are held I hope that I will be apart of them. Due to the way our system works it is sometimes hard for me to be at every hospital and lecture on campus at the same time. Therefore, I am hoping maybe I can phone in or be there via through an email update. I want to get as much feedback, and information from the clinical instructors as they will see with my lead measure how the students are doing while they have 35 to 40 minutes posting on their eportfolios what their challenges are. They will be able to bring any information from that to our WIG sections.

I will have to send out a weekly agenda to keep us to date:

    1. How much time did the student’s get to spend on their portfolios?
    2. What were your struggles with giving feedback via the e-portfolio?
    3. What is our plan of action this week?

4DX vs. Influencer Strategy

I believe that the influencer strategy and the 4dx have the same idea but different concepts. The influencer strategy focuses more on social and emotional behaviors. How can you make a change by demonstrating and imitating others who have already done it correctly. While 4 Disciplines of Execution is stating accountability and focusing on the mustard. When I mean the mustard the grit the detail. Not the big picture. What is it that we need to do to really get down and dirty and make that change to get what we need done to make it work. They are saying if you follow these steps your big picture will come and you will be able to master that one goal.


Grenny, J., Patterson, K., Maxfield, D., McMillan, R., & Switzler, A. (2013).

             Influencer: The new science of leading change: 2nd ed.

             New York: McGraw-Hill Education

McChesney, C., Covey, S., & Huling, J. (2012). The 4 disciplines of execution:

           Achieving your wildly important goals. New York, NY: Free Press. 

Influencer Strategy

Influencer Strategy

Throughout the many assignments and coursework that has been assigned to us through the DLL program I have realized my one key goal is reflection. I believe that reflection is key to my student’s success and overall goal to becoming Registered Therapists. If they have a platform like e-portfolios it would give them access to reflect back on the daily activities and competencies that are to be met.

One of the first steps to doing that is finding a few students to become a focus group and measure their outcomes. My goal is to have my incoming class in 2019 to begin their program with e-portfolios of their choosing. I will be at 100%  program wide by 2020. Also, would like at least 50% of my instructors, administrators, and cohorts to be involved in feedback of their learning or developing their own profiles to model the behavior by Fall 2019.

Below, you will find my results I would like to achieve, vital behaviors, how they will be measured, and who are my organizational influencers.


Below you will find my six sources of influencers it shows how we will model through personal, social, structural motivation and ability.

6-influencers_338004786 influencers


Grenny, J., Patterson, K., Maxfield, D., McMillan, R., & Switzler, A. (2013).
               Influencer: The new science of leading change. New York, NY: McGraw-Hill.



Why: We believe to empower students looking for their passion with the skills, knowledge, and develop them into great Respiratory Therapists.

How: We will create motivational and engaging learning environments in clinical and on campus classes.

What: To develop an e-portfolio that showcases a reflection of the skills that they have developed throughout the program to become Respiratory Therapists.

When I attended respiratory school I would go on from semester to semester forgetting little things that I would remember. Each semester, the things you learn builds on top of each other. Therefore, those key little things become very important. I would have to reflect back on my handwritten notes to remember and review the information. If respiratory students had the chance to use an ongoing system that could keep up with their presentations, notes, journals, blogs, and lectures I believe it would help with their learning. Our program would see better outcomes from the students and in turn better Respiratory Therapists.

I remember, starting my first job after graduating respiratory school and training with the other therapist I was amazed at all the skills I either forgot or the details that I missed.  I was really good at trying to jot everything down when my instructors brought up interesting details, new equipment, or easier ways of getting things done. Although, if I had an e-portfolio to take pictures, jot my ideas down, and blog about how my day in clinical went I could had reflected back once I began my career. I would have been able to use this information from semester to semester. Throughout, the years things change our memories fade, it is good to have a reflection piece to use.

Heart of Change:

How do we really affect someone, is it by their mind or heart? Why do we all feel that the mind controls everything? Commercials tend to use the mind for children by focusing on the best and newest toy, they affect the mind. But, how do we really affect someone, we have to affect them emotionally?

When, I think of my why I think of my patients first. First, because I want the best for my patients, my parents, my children, my sister, her kids, my friends, and the world. I want to develop, train, and mentor the best respiratory therapist that possibly can be. I want to make a change. That is my why.  Emotionally, you cannot be in the health field and not let it affect you at some point. Someone’s husband, wife, mom, dad, child, brother, sister, and friend you have either help save or could not help save.

Therefore, I have to to relate to my students not only mentally but emotionally. Being in health careers it is very important to emotionally to connect with our students. Without, the emotional connection they fail to understand why we are learning.  When, I bring up stories from personal reflection at the hospital or family they tend to emotionally connect with me. Therefore, the first question I ask them when they say I am interested in the respiratory care program is “Why do you want to become a Respiratory Therapist?” I need to know why, then I emotional connect with them. When you are more emotionally invested in something you will tend to work harder for it. Therefore, when a students why is because of a loved one they have seen suffer due to a bad respiratory disorder they seem connect faster.

Sense of Urgency:

What is change if you do not have a sense of urgency? Will anyone even care about your plan if you don’t feel like there really is a need for it? If you aren’t excited for feel like there is a need for it, is there really any point in making a plan for it?

No one, is going to make your plan a priority if you don’t make your plan the number one priority. I know this from experience. Starting last year our health careers school implemented an annual interdisciplinary disaster mass causality simulation. This year no one has made it a priority or made it feel like it was of high priority. Everyone is walking around campus like if we get it done we get it done. I am not the one that is leading the organization of this simulation. I only have 23 students involved versus some who have 200. The simulation is less than three weeks away and the sense of urgency does not feel like it is there for the disaster to be performed.

I need to establish a sense of urgency when it comes to my innovation plan. I realized that after reviewing the material and talking with Dr. Thibodeaux this week. When creating my plan to implement E-portfolios I knew their was a need and I know their is a need for urgency. Therefore, the longer I wait to implement something the less effect our plan has. It tends to fizzle out and eventually goes away. The time is now!


Kotter, J. (2011, March, 23). The heart of change. . Retrieved from

Kotter, J. (2013, August, 15). Leading change: Establish a sense of urgency. . Retrieved from

Sinek, Simon. (2013, September 29). Start with why. Retrieved from

Implementation Video

My first thought was what could I do to catch my audience? What can I do to persuade them to jump on my side to be motivated about e-portfolios? Well, tell them the facts! I believe E-portfolios will take my students to the next level in our program and help them move on each semester and not forget information learned. With this video I hope other will see my view as well.

My video was made with Adobe spark and used their images as well as their music.

E-Portfolio Implementation Outline

Building an E-Portfolio While Learning to Become a Respiratory Therapist

Proposal Outline

Instructor turnover, limited available hours, and assessing are all factors to consider when integrating E-portfolios. The purpose of my plan to integrate E-portfolios into the Respiratory Care Program is to help have a learning platform to reflect back on, build a resume, and use after graduation to help reflect on information they need to study for their boards. This outline is the first step leading to e-portfolio implementation into my program. With the addition of free resources available to my students I think this will allow them to reflect back on their learning in an authentic way.

This proposal involves multiple phases, at this moment I cannot predict the best time for implementation. The students will have a choice and voice when creating their portfolios.

Link to: Implementation Outline

The Need to Change

I loved Sir Robinson’s argument so much I watched it numerous times! I am in total agreement with him. It tells me that our education has built a system for these crazy outcomes and that every student must be the exact same no matter their background, level, or learning ability. That is not the real world. We all come from different walks of life.

I believe that we should focus on the student and use the technology to teach the student. The number one goal is the student.

I love how he said not everyone needs to go to college or at least for now. There is so much pressure on students to pick a career in college instead of waiting to decide what they really have a passion for.  I never knew my passion was going to be teaching. I thought in school I would want to teach Agriculture, but while in college others in the program discouraged me so I changed my mind.  Years later I went back to Respiratory School and now I am an RT. I love being a  Respiratory Therapist and I love the fact I get to teach what I love.  Therefore, my day flies by I tell my husband I feel like I never have enough time. Eight hours isn’t enough to accomplish what I need to with my students. I am so passionate about it.



What do I think about Disruptive Innovation?

Disruptive innovation is nothing I have ever thought of till this point! When you think of disrupting something you think of bothering someone or doing something wrong. In this circumstance it is making a huge change in how we educate our students. When I think back to the videos I think about how they spoke about some of the students love to work from their desk at home or they are stay at home moms but still like that face to face contact. They feel rewarded by going to college even though they are at home with their little one. And, having the capabilty to learn from a live face-to-face lecture in their livingroom is shaking up the world that we live in.

We are so use to the usual, the normal, the standard of sitting in the classroom and listening to the teacher or professor lecture. That is what we grew up on. Now there are so many outlets out there to bring the classroom to you.  My campus has one health care discipline that provides satellite locations, online lectures, and weekend courses. My discipline has not took this on quiet yet. I see that their is a need for this and I have tried to implement more online resources this semester for the students to work on outside of class.

I like them being about to do things on their on that is readily available to them online then making them do busy work in the classroom. Where I can use that time to lecture on the topics that are the most important, show them the correct way to do things, as well as use that time for assessments. Since, doing this over the summer with them I seen a great change in their learning. Students like to have the option on how to work on their assignments outside of class I have learned.

When I think of blended learning I think of technology. I believe it is because technology has driven this force. If it wasn’t for the affordable apps, ipads, lap tops, or the Internet it would not be made possible. And technology is ever changing. But, they are right we need to focus on more of the education than the technology. We need to take the tools and use them for our audience.  I am still working on a way of implementing e-portfolios for my students to use them as resume’s or reference on what they learned throughout my program or for job interviews in the future. It has already been a crazy start and have been able to implement different things that I have learned over the last few months in our classes.

How to implement E-Portfolios into Respiratory Care

Dear Respiratory Care Program Director,

Currently, my Respiratory Care students utilize a program to track their clinical hours, doctor interactions, journal entries from their week at, as well as, competency check offs. Once they graduate the program they never access this information again. Therefore, I am proposing the use of e-portfolios to make their experience more authentic to them. They could use their e-portfolio platform to post their doctor interaction, journal entries, and competency check offs as blog, video, presentation, or whatever outlet they find best suited. They could reflect on this information, if they forget a procedure or information.

I’m proposing a solution that could make the student take ownership of their learning. As well as, creating a platform for them to grown throughout their two years in the program. They will be able to build their profile and take with them post-graduation as a resume.

I am proposing to initiate an e-portfolio in which:

  • 1st year students would be oriented on how to build their e-portfolios. Along with, literature, discussions, and videos to be posted on blackboard for guidance on “How to build your e-portfolio.”
  • I will give the student the power to choose which site they would like for their e-portfolio
  • The student would be able to build their site with their educational and clinical development.
  • Students could use their site to show achievements, credentials, certifications, and utilize it post-graduation as a resume.
  • Students would be able to access their e-portfolio after graduation to add accomplishments in their professional career as a Respiratory Therapist.

Do to the dynamic of the program the student would have little time to work on this in the classroom. We could dedicate eight hours during orientation days, while the rest of the time would be spent independently at home.  If we implement the e-portfolio their freshman year they will be able to apply the foundation from their first day of the program. They could build upon it and rely back to the information when they return each semester. It usually takes the students a couple of weeks to remember information after a long break. This could be used as a refresher and their learning hasn’t been lost.

I would like to propose that we add e-portfolios to the clinical course throughout the Respiratory Care Program requirement to track clinical and educational development. I believe this will engage and motivate students to be more creative in their learning experiences, in addition to, have a virtual resume to take with them after graduation.


Jessica Hudnall

Apps to Help Engage My Learners

Over the last few weeks, I have began to develop my e-portfolio more in depth, organize it, and clean it up. Along with all of that time that has been spent I have reviewed many others in my class and past classes ePs that are related to different fields, careers, and levels of education.

Also, we were asked to create a group to have for feedback, guidance, and support.  My group has been a lifesaver to me through this last five weeks. I have learned so much from them. Although, we are all in different fields, and areas we have a common interest to teach and engage the adult learner. I am new to education and they have opened up my mind to many different phone apps and sites to help teach and engage my learners. I am excited to find a way to implement them this Fall. Below, you will see my five goals to help enhance my teaching techniques, engage my students, and guide them threw their learning process.

I believe with the start of this process it will help me become a better Digital Learning Leader. I look forward to my change with my new class next week.